The role of neutrophil‐to‐lymphocyte ratio in men with erectile dysfunction—preliminary findings of a real‐life cross‐sectional study

Abstract

The aim of this study was to investigate the role of systemic inflammation by means of the neutrophil-to-lymphocyte ratio (NLR) in men with erectile dysfunction (ED). Complete demographic, clinical, and laboratory data from 279 consecutive men with newly diagnosed ED were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). A complete blood count was requested for every man, and the NLR was calculated for every individual. Patients were invited to complete the IIEF questionnaire. Logistic regression models tested the odds (OR, 95% CI) of severe ED (defined as IIEF-EF <11, according to Cappelleri's criteria) after adjusting for age, BMI, comorbidities (CCI >0), metabolic syndrome, NLR, cigarette smoking, and color duplex Doppler ultrasound parameters. Likewise, LNR values were also dichotomized according to the most informative cutoff predicting severe ED using the minimum p value approach. Median [IQR] age of included men was 51 [40-64] years. Of all, 87 (31%) men had severe ED. Men with severe ED were older (median [IQR] age: 61 [47-67] vs. 49 [39-58] years) and had a higher rate of CCI>0 [46/87 (53%) vs. 44/192 (23%) patients]. Thereof, NLR was dichotomized according to the most informative cutoff (NLR>3); patients with severe ED more frequently had NLR>3 as compared to all other ED patients [namely, 18/87 (21%) vs. 13/192 (7%)]. At multivariable logistic regression analysis, NLR>3.0 emerged as an independent predictor (OR [CI] 2.43 [1.06; 5.63]) of severe ED, after accounting for other clinical variables. A NLR>3 increased the risk of having severe ED in our cohort, boosting the already existing evidence linking systemic inflammation to ED. Moreover, this easily obtainable index can be clinically useful in better risk-stratifying patients with ED.

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

“…Therefore, NLR is better to indicate the impact of these two white blood cell subgroups than focusing on neutrophil alone (Azab et al, 2010). Likewise, our findings (Ventimiglia et al, 2018). Another study demonstrated that systemic inflammation negatively affects the possibility of sperm retrieval in TESE (Yucel et al, 2017).…”

“…Ventimiglia et al . reported that NLR decreases as a function of increasing ED severity and NLR > 3 as the most informative cut‐off for identifying men with severe ED (Ventimiglia et al ., ). Another study demonstrated that systemic inflammation negatively affects the possibility of sperm retrieval in TESE (Yucel et al ., ).…”

“…Our study revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) discrimination of the phases of PD for the NLR. Various cutoff values have been found in different studies for NLR ranged between 1 and 5 (Nishida et al ., ; Yucel et al ., ; Ventimiglia et al ., ). Forget et al .…”

“…Our study revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) discrimination of the phases of PD for the NLR. Various cutoff values have been found in different studies for NLR ranged between 1 and 5 (Nishida et al, 2017;Yucel et al, 2017;Ventimiglia et al, 2018). Forget et al have identified the normal range for NLR in an adult, non-geriatric, population in good health are between 0.78 and 3.53 (Forget et al, 2017).…”

“…Inflammation parameters such as the neutrophil-tolymphocyte ratio (NLR), the monocyte-to-eosinophil ratio (MER), and the platelet-to-lymphocyte ratio (PLR) are simple and feasible markers that are easily calculated in the complete blood count (CBC). Moreover, there are various studies in the literature investigating the importance of NLR, MER, and PLR in andrological diseases (Yucel et al, 2017;Ventimiglia et al, 2018;Cito et al, 2019).…”